Treatments for Bladder Cancer
The treatment options or medications for bladder cancer depend largely on the advancement of cancer. The treatment is different for the early stage non-invasive bladder cancer and the more advanced muscle-invasive bladder cancer.
During treatment, all hospitals have multidisciplinary teams (MDTs), who are cancer specialists. These teams usually work together and come up with the best treatment of a patient's cancer depending on its stage.
The members of these teams include:
- Radiologists- the work of a radiologist is to detect cancer by the use of imaging techniques.
- Urologists- this type of doctor is a surgeon, who specializes in the treatment of all conditions related to the urinary tract.
- Pathologists- are specialists who deal with diseased tissues.
- Clinical Oncologists- specialize in radiotherapy and chemotherapy.
Deciding the best treatment for your bladder cancer can be difficult. Your MDTs will always make recommendations for you so that you can choose and decide the treatment method you want to undergo. It is important for you to ask your MDTs questions before discussing any treatment options.
This article will describe the most common treatment methods for bladder cancer and will also give general approaches for each treatment option based on the stage of your bladder cancer. Treatment options depend on the stage of bladder cancer, but it can be divided into two:
- Treatment for nonmuscle-invasive bladder cancer
- Treatment for muscle-invasive bladder cancer
Your care plan will also include the treatment of all possible symptoms and side effects coming from any of the medical procedures.
Nonmuscle-Invasive Bladder Cancer
If your doctor diagnoses you with this type of bladder cancer, your recommended treatment plans depend mainly on the risk of your cancer spreading to other parts of the bladder.
The risk depends on a number of factors such as:
- cancer cells grade
- a history of bladder cancer
- the size of the tumors (in case they are larger than an inch)
- the number of tumors present in the bladder
Treatment Options for Nonmuscle-Invasive Bladder Cancer
1. Low-risk
For low-risk nonmuscle-invasive cancer, your bladder is treated by the use of transurethral resection for bladder tumor (TURBT). This option is the first cystoscopy procedure performed, wherein a tissue sample is taken to the laboratory for testing. During TURBT, your surgeon uses a cystoscope to locate any tumors in your bladder. If any tumors are identified, the surgeon cuts them away from the bladder's inner lining and then seals the wound by the use of a low electric current. During surgery, you may be given a catheter to drain any tissue debris or blood from your bladder for a few days.
After the surgery procedure is complete, you are administered with a dosage of chemotherapy targeting only your bladder. A solution for the chemotherapy is administered using a catheter and is kept in your bladder for about an hour before it is drained out.
After this type of treatment, you are required to have a follow-up appointment with your doctor for three to nine months to check for any recurrence of your bladder cancer. If your cancer is diagnosed again, maybe after six months, fulguration of the bladder is advised. This treatment involves the use of a moderately stronger electric current to destroy all cancerous cells.
2. Middle-risk
Individuals with middle-risk nonmuscle-invasive cancer of the bladder should have six or more doses of chemotherapy. A chemotherapy liquid is administered directly into your bladder by the use of a catheter and then it is allowed to stay for about an hour before it is drained out.
After this kind of chemotherapy, you should go for a medical follow-up at intervals of 3, 9 and 18 months, and after that, once a year. During your appointments, your bladder is observed through cystoscopy. In case you are diagnosed with bladder cancer for the second time, you will be referred to a team of urologists.
3. High–risk
A second operation of TURBT should be offered for those people with high-risk nonmuscle-invasive bladder cancer. This procedure should be done within the first two weeks of the first clinical investigation. There is also a need for an MRI and CT scan to diagnose this type of cancer. Your medical practitioner will discuss with you the best treatment options for this stage of bladder cancer, which include:
- Cystectomy - is an operation to remove the whole urinary bladder.
- Bacillus Calmette-Guerin (BCG) - a variant of BCG can be used in this treatment.
In case treatment with BCG doesn’t work or maybe the side effects are very strong, you will be referred to a urologist. A follow up is done at intervals of three months for the first two years of BCG treatment, and then an interval of six months for the next two years, and finally, once a year. During your follow-up appointments, you will be checked for any cancer through cystoscopy.
In case you will consider cystoscopy as your treatment, your surgeon will create a new way for your urine to leave the body, which is referred to as a "urinary diversion." After cystectomy, you are required to go for checkups every six months. During these appointments, blood tests and CT scans are performed to diagnose any traits of cancer.
Muscle-Invasive Bladder Cancer
The treatment of this stage of cancer depends on how far cancer has spread. T2 and T3 bladder cancer medications are aimed to control cancer for a long time or possibly cure it.
For the treatment of muscle-invasive bladder cancer, a urologist, and other health specialists, will discuss with you the best treatment measures for this stage of cancer. The treatment measures can either be:
- radiotherapy
- chemotherapy
1. Radiotherapy
Radiotherapy is a procedure achieved through subjecting the bladder to radiation. Beams of radiations targeting the bladder are given everyday for five days a week taking a period of four to seven weeks. Each radiotherapy session takes about 10-15 minutes to complete.
A radiosensitizer is also given alongside radiotherapy in the treatment of muscle-invasive bladder cancer. This drug is aimed to sensitize the tumor cells so as to enhance the radiotherapy.
Instead of only destroying cancerous cells, radiotherapy can destroy healthy cells as well, which means that it has many side effects. They include:
2. Chemotherapy
Chemotherapy is a procedure that uses drugs to kill cancerous cells. If chemotherapy is used to treat muscle-invasive cancer, two or more drugs are used to increase its effectiveness. Instead of administering drugs directly into the bladder, the drugs are administered through a vein in your arm. This method is referred to as "intravenous chemotherapy." Chemotherapy is used together with radiotherapy just before surgery, before surgery and radiotherapy to reduce the tumor size, and to prevent the spread of an incurable advanced bladder cancer.
Chemotherapy is mainly used to kill cancerous cells that remain after surgery or radiotherapy.
The Bottom Line
Bladder cancer is a very serious and painful condition that affects many people around the globe. Different medications have been brought on the table for the treatment of bladder cancer at its different stages. Bladder cancer is a condition that can be treated at nonmuscle-invasive and muscle-invasive stages. It is unfortunate that the chances of curing metastatic cancer are slim. Even if bladder cancer can’t be treated at this stage, you can still live with it by using some drugs to relieve the symptoms.
